Objective-In endothelial cells, cyclooxygenase-1 (COX-1) and COX-2 both contribute to prostacyclin production. Recent findings suggest that COX-2 contributes significantly to systemic prostacyclin synthesis in humans; whether COX-2 inhibition is related to an increased cardiovascular risk is undergoing debate. HDLs have been shown to increase prostacyclin synthesis, thus in the present study we investigated the molecular mechanisms involved in this effect in endothelial cells. Methods and Results-HDL 3 (30 g/mL) induced COX-2 expression in a time-and dose-dependent manner. COX-2 was found mainly in the perinuclear area where it co-localizes with PGI synthase. Transient transfection experiments showed that CRE is required for HDL-induced COX-2 transcription, and we demonstrated that p38 MAPK activation by HDL 3 is involved in COX-2 mRNA transcription and stabilization. As a consequence of COX-2-induction by HDL 3 prostacyclin production increased, incubation with a COX-2 selective inhibitor blocked this effect. Moreover, HDL 3 increased caveolin-1 phosphorylation, thus promoting PGI-synthase shuttling from the membrane to the perinuclear area. Conclusion-We conclude that in endothelial cells, HDL modulates COX-2/PGI-S activity via both p38 MAPK-dependent COX-2 mRNA stability and transcription and both caveolin-1-dependent PGI-synthase shuttling and COX-2 coupling.The understanding of these mechanisms may provide new insights into the antiatherogenic role of HDL. Key Words: HDL Ⅲ cyclooxygenase-2 Ⅲ p38 MAPK Ⅲ prostacyclin Ⅲ caveolin-1 H igh-density lipoprotein (HDL) protects from atherosclerotic vascular disease. 1 Beyond reverse cholesterol transport, HDL particles posses several anti-atherosclerotic effects, 2 including the induction of prostacyclin (PGI 2 ), a strong vasorelaxant 3 that acts also as an inhibitor of platelet and leukocyte activation. 4 The stimulatory effect on PGI 2 depends mainly on the supply by HDL of endothelial cells with arachidonic acid. 3 The rate-limiting step in the conversion of the arachidonic acid to eicosanoids is the activity of cyclooxygenase (COX). 4 Two major forms of COX, COX-1 and COX-2, have been identified. 5 Although COX-1 is constitutively expressed in most cell types, COX-2 is induced by various growth factors and cytokines. 6,7 Recent findings suggest that COX-2 contributes significantly for PGI 2 synthesis in endothelial cells, 8,9 whereas COX-1 is mainly involved in TXA 2 synthesis by platelets. 8,9 Whether COX-2 inhibition is related to an increase of cardiovascular risk is uncertain. 10 HDL induces COX-2 expression in rabbit smooth muscle cells 11 and cooperates with TNF-alpha to elicit this effect, 12 the molecular mechanisms involved, however, are unclear. COX-2 expression is modulated by growth factors and cytokines via mitogen-activated protein kinase (MAPKs) cascade. 13,14 Once activated, the MAPKs may modulate the activity of several transcription factors such as CREB, NFAT, AP-1, and NF-KB, [15][16][17] which are involved in COX-2 expression. 18 -21 In the...